Dental practices often receive requests to access dental records from people other than the patient.

One of the most common questions we are asked at JFH Law is whether a dental practice is obliged to disclose notes to officials, such as the police or social services. It is understandably hard to refuse to disclose patient notes to a police officer during the course of a missing person or criminal investigation. However, it is important to remember that data protection laws prevail and real consideration must be given to when and why notes are being disclosed.

Whilst GDPR is at the forefront of everyone’s minds right now, a practice also needs to consider professional duties of confidentiality, the common law duty to disclosure in the public interests and the rules contained within the Access to Health Records Act (1990).

In this article we clear up the confusion over who actually does has the right to access a patient’s records and in what circumstances, and how dental practices should respond to these requests?

Living Patient’s Records

If you receive a request from an external body, such as the police or social services, in respect of a living patient’s records, you must consider this carefully before disclosing anything. There is no automatic right to access, not even for the police.

Unless there is a specific court order for disclosure, you will need to consider whether the disclosure would be justified in the ‘public interest’. An example might be if either the patient or someone else was at risk of serious and imminent harm if the notes are not disclosed. You should try to seek informed consent first, but if this is not possible weigh up what is being requested against why it is needed to decide whether disclosure would be justified. Either way, make a clear record of why you have reached the decision you have reached, and why you believe it would be in the public interest to disclose any notes if you chose to do so.

GDPR would also apply in this situation. You could potentially rely on ‘protecting vital interests’ as the lawful basis for disclosing notes. However, this can only be relied on if you need to process personal data in order to protect someone’s life and they are not capable of giving consent. There are very few circumstances that this could be said to be the case for dental records.

If another dentist or health care professional requests the notes, then you will need to satisfy yourself that the patient has consented to disclosure to this third party, in accordance with GDPR and your professional duties of confidentiality. There is no such thing as “off the record” as such it is not lawful to send non-anonymised case records to other practitioners or specialists without the consent of the patient.

If the patient asks you for the records, whether in writing or verbally, but requests they be sent to another dentist then you must comply with this also. The only caveat is if you are concerned that the patient does not understand what the implications of the disclosure might be; you should explain what will be disclosed and check the patient is still happy to consent.

Deceased Patient’s Records

The duty of confidentiality extends beyond the death of a patient. This must be borne in mind when deciding if access to the records will be granted to anyone else. Ultimately, if the patient explicitly states whilst alive that they do not want their records disclosed on death, then this wish must be adhered to.  

The Access to Health Records Act (1990) allows access to records to two defined categories, namely:

1. The patient’s personal representative, namely the executor of the will or administrator of the estate;
2. Any person who may have a claim arising out of the patient’s death.

You do not need to provide access to all of the dental records when requested by the above, only information that is relevant to any claim being pursued. This may require you to obtain from the requester more information as to why the request is being made so you can determine what information should be provided.

You may also receive a request to access the notes of a deceased patient from a coroner (or procurator fiscal in Scotland). As they have a legal obligation placed on them to investigate the death, you must provide them with access to the records.

You may also be asked by the police to provide certain information to help identify a body. In these circumstances disclosure would be justified as being in the public interests.

Remember GDPR applies only to living data subjects and so would not be relevant here.

Practical Tips

Whenever you receive a request you should:

• Make sure you understand what is being requested and why;
• Satisfy yourself that the person making the requests, is who they say they are;
• Train staff to ensure they understand GDPR and patient confidentiality and can identify when a request for information is being made;
• Don’t be bullied by officials, who claim to have a right to access, but are unable to identify the lawful basis for disclosure;
• Where applicable try to seek the patient’s consent to the disclosure first;
• Always consider the wishes of the patient, whether living or deceased;
• Make a clear note on the file of any decisions made and why.

If you have any questions about the content of this article please feel free to email Laura Pearce on This email address is being protected from spambots. You need JavaScript enabled to view it. or telephone 0207 388 1658.

Laura Pearce

Senior Solicitor

Image by vjohns1580 from Pixabay

Mark Oborn-dental-marketing-trackers-hunters-explorers

In the last blog post we looked at the meaning of dental marketing, how (in my opinion) it should change in dentistry and focus entirely on the patient. I talked about flipping the focus of our marketing to not be about what we can sell as a practice or be about the treatments we want to do, rather, it should be about solving patients problems in an engaging and relationship building way. The natural result of that is that people are attracted to us.

In this post I'm going to begin looking at some of the more specific ways that we can make that happen, future posts are then going to look at each of these individual ways that we can build relationships with patients.

When we look at digital dental marketing is useful to break down into 2 primary areas:

1. Traffic optimisation to a dental practice website, this typically includes:
   • search engine optimisation
     • On-site search optimisation using words and phrases
     • offsite search optimisation with articles linked back to your website which Google sees as votes
   • paid advertising (PPC)
   • social media marketing
   • e-mail marketing via permission-based list building on your own website
2. Conversion optimisation to get more of those website visitors converting into patients, this typically includes:
   • calls to action and wording on the website
   • things for prospects to do, typically these are downloadableguides which are handed out in exchange for an e-mail address
   • e-mail marketing
   • social media campaigns

Now that you've broken down digital marketing into very specific areas you can begin to understand more about whether you can do this yourself, who could do it in your practice or what you may need to outsource.

In general, I recommend 3 marketing strands:

1. your website
2. e-mail marketing
3. social media marketing

Each of these should work in unison, as a system, referring patients backwards and forwards to the correct pace at the correct time in order to answer their dental problems and subsequently to gently attract them into your practice.

No single strand is more or less important than the other.

This is typically how I might approach this.

Patients that engage with you in some way via your website or social media stream  may not be ready to book an appointment straightaway, They may be:

• TRACKERS : They know exactly which treatment they wish to buy and are using your website to check the price, availability and your service.
• HUNTER: They don't have a specific treatment in mind yet but they do know what type of treatment they are looking for e.g. orthodontics, they probably have a few more features in mind. They are using your website to compare alternative options.
• EXPLORER: They don't have a particular treatment in mind yet but they may have a particular objective e.g. straighten crooked teeth. They may even be looking on behalf of someone else.

We therefore need to provide things for each of these people to do, in order that they can feel as though they have taken action whilst on your site (at the same time we get to collect their information!)

For the respective categories this should be:

1. HUNTERS or EXPLORERS: Free guides and downloads for patients wishing to solve a dental problem.
2. TRACKERS or HUNTERS: An incentive to request an appointment, this could be a free consultation, refund of initial assessment or explicit promotion of your new patient health check. This will help to convince patients if they are wavering about requesting an appointment.
3. TRACKERS: A request an appointment facility.

As you can see, explorers are not going to book an appointment yet, so what are you going to do to ensure you don’t lose them at this early stage in their decision?

We are using social media to drive people to your website, your website to collect their details, e-mail marketing to answer their questions which then sends auto responses (assuming we have permission) to drive them to make an appointment if appropriate.

Most of this is automated and all of it will work 365 days of the year, 24 hours per day. Never sleeping!

My opinion is that if you don't use all of these mechanisms, all of them working today as a cohesive system then your digital marketing will be less effective and you will be able to help fewer patients.

In the next article going to go through marketing on your website specifically, looking more at hunters, trackers and explorers and how you can get your site to be more effective.

Until next time…